I have been suffering from severe depression and my GP has refered me to the community mental health team. I have an appointment with a psychiatrist on Tuesday.
What can I expect in this appointment? If someone else who has been through a similar process could comment I would appreciate it.
I'm in exactly the same situation. I have my first appointment on Monday and I'm getting cold feet. I don't see how talking cam help me.
It is not going to make you any worse though. I would keep it f I were you.
I know, I will go
Hi there, I don't know if your experience will be the same but thought maybe if I told you what happened when I went it might be of some use?
I too was suffering from severe depression, got referred to community mental health team and for appointment with psychiatrist.
On the day of the appointment I first met with a mental health nurse who was part of community mental health team.
We talked for about 40mins to an hour while she took a history from me regarding how I'd been feeling, for how long, any significant events. All of the things you'd expect to be asked by your GP really.
It was all done in an environment they'd obviously tried to make look homely and comfortable; offering cups of tea and the like as if you're just having a chat with your friend.
The nurse then fed back the information i had given her to the psychiatrist.
Then I met with the psychiatrist and he talked more about some things he wanted more information on, and the nurse stayed with me the whole time.
The psychiatrist gave me my diagnosis, suggested a few new medications to try that my GP hadn't thought of yet, then wrote to my GP with his assessment.
All in all it was pretty much what you'd expect, if you've ever had any kind of appointment in counselling or CBT or psychology or anything like that then most introductory appointments are quite similar.
Basically you just outline your problems in your own words to them. The appointment I had certainly wasn't intimidating at all and they'd obviously gone to great lengths to make this the case.
I hope this is of some help, if you've got any more questions feel free to ask.
I'd definitely go to the appointment though, it could end up being really beneficial to you.
X
You have summed it up really well.
Thank you!
X
That emoticon wasn't supposed to look so scary lol don't know what happened there! X
Can a psychiatrist prescribe medication?
Yes, but they usually write to your GP with recommendation, but in a hospital setting they will prescribe
I'm pretty sure they can, I think that's one if the main differences between psychologists and psychiatrists.
I'm pretty sure a psychiatrist has to be a doctor of some kind that has decided to go down the route of mental health (don't quote me on that one, but that's my understanding).
The psychiatrist I saw certainly had a much more in depth understanding of different medications I'd never even heard my GP mention before.
In my case the psychiatrist didn't prescribe me any at the actual appointment, but instead wrote to my GP telling them what to prescribe me.
I think this was only because I had to taper off the medication I was on in order to start the new one and so he didn't want to give me the new meds straight away whilst I still had the old meds in my bloodstream kinda thing.
X
My mistake, it's actually a psychologist I'm seeing. Can they prescribe?
Thanks a lot for such a detailed reply
I am concerned about disclosing my current suicidal thoughts to the psychiatrist. I have been having thoughts to the point where I have spent hours at a time reading up on suicide and other people who have killed themselves and thinking of ways to kill myself.
Additionally, I have also been down to the river thinking of throwing myself in but found it too frightening to go through with it. I do not want to be sectioned or refered to the hospital.
No I'm almost certain they can't.
I have been seeing my psychologist for about 5 months and there's been no mention of prescribing, actually he has told me to visit my GP for prescriptions in the past so I'm pretty much sure they can't.
Psychologist appointments are more like in depth counselling sessions. They talk with you about your issues rather than just being somebody to listen to you, like you get if you phone the Samaritans or see a counsellor or something.
They can offer up strategies for coping with your problems, help you delve deeper into what's causing them, suggest ways of changing negative patterns of behaviour, give you things to read that you may find useful, and give you information on other services that may be useful to you. It's a lot of talking and really getting to understand what's going on to make you feel the way you do.
I have found it best to be completely open and honest with the psychologist in terms of your actual problems, but also in terms of your treatment plan.
For example some talk a lot about breathing exercises and meditation and things like that, now I personally don't find those methods helpful. I know some people do, but I just don't.
With my first psychologist I was too scared to say I wasn't doing my breathing exercises because they weren't helping me, and ultimately we didn't get very far. With my new psychologist I tell him straight away what is working and what is not. He appreciates it because he isn't wasting his time talking to me about things I don't want to know about, and I appreciate it because I get more from the sessions by him suggesting methods that do work for me.
I'm assuming this is your first appointment with a psychologist, if its not many apologies for sounding patronising!
Best wishes x
I know this fear myself.
Sometimes it's difficult to know how much to disclose for fear of things getting worse.
If you can, I would be honest with them.
The last thing anybody wants is for anyone to commit suicide (please don't!), so it does set alarm bells ringing in their heads sometimes.
But maybe that's a good thing, if you tell them just how low you are feeling to the point of suicide, they may be able to offer you more support in the community, more support with everything really, a better medication that suits you more, more opportunities to talk.
The important thing is that you haven't harmed yourself, despite how bad you've been feeling and that shows strength and deep down a desire to get better.
If they think you are an immediate risk to yourself they may refer you to hospital. I know that's not what you want but it might be what you need to keep you safe and well.
They quite often ask about support you have at home and are often reassured if you have a friend or relative aware of your situation who you could call if things got really bad.
Please try to be honest in your appointment, it could be a great relief even to just say the words and not feel like you're carrying around some kind of secret. And they really will do all they can to improve how you feel right now.
Please stay safe.
Best wishes x
It is my first appointment and I think the fact that you've been seeing your therapist for five months just proves my point. You have talked about your problems for that long and, I assume, you still need more therapy? I don't expect a quick fix, but I have to be honest, talking will not change my circumstances and that is what I need to change.
I totally understand where you are coming from.
But honestly, just give it a bit of a go.
I felt exactly like you before my first appointment and I told the psychologist as much. I had quite a standoffish attitude actually because I'd seen a psychologist, CBT therapists and counsellors in the past and gotten no where.
So we made an agreement I'd do 4 sessions and if I genuinely didn't feel we were making any progress we would stop. I didn't think I'd see any changes, but I did.
Now yes, I am not "better" or anything remotely of the sort but I do have a better understanding of my problems and where they could stem from and how I could try and deal with them.
Also just to point out in my area you get 18 sessions with the psychologist, so although I've been seeing him for 5 months I've only seen him 9 times, roughly once every fortnight. So I'm only half way through my intended course of therapy.
I can already feel an improvement in my life, so hopefully at the end of the treatment I will feel even better.
You're right talking wont change your circumstances, but it might help you understand how/why you've wound up in those circumstances, how to not be in them again, and that can help.
Please try and go into it with a bit of an open mind? At least give it a go maybe? It's really not my decision to make, but all I can say is I'm glad I did it.
X
Just to clarify: a psychiatrist is a medical doctor (specialist in mental health, like a cardiologist is a specialist in hearts) who prescribes medication. They don't generally do ''therapy'', counselling etc, but are there cos they're experts on the drugs and give diagnoses. In my experience they're far better than GP's for medication as GP's only have a general overview of the drugs and don't have so much experience. Psychologists/psychotherapists do the talking therapy/CBT etc. I really feel for you, feeling so bad, I have been there and am actually there again at the moment. It may be a good idea to see a psychiatrist to get you on some medication which will help you out of the deepest part of the pit before the psychologist will be able to help with the therapy. Good luck with it all
Thanks a lot for your encouraging reply. My GP has been concerned about me and told me that she lost a patient to suicide and certainly does not want to lose another one, she told me how distressing she found it.
How did you find the community mental health support? What did it consist of?
Thanks so much for your kind and thoughtful posts
I have been referred to psychiatrists in the past as well as had counselling and seen community nurses and psychologists.
Out of all of them, I would say that the psychiatrist is usually the most 'clinical' and least sympathetic, because their job is really just to work out whether you need a prescription of anti-psychotic medication which is normally too specialised for a GP to prescribe, and/or to work out if maybe you do need sectioning.
Sorry to make it sound like a not very nice experience, but for me it wasnt. I would go to it though if I were you because you might have a better experience.
I was prescribed anti-psychotics, which helped for a while, but I came off them when I realized that they make you put on weight.
I still struggle with depression but find talking therapy and other things like massage help quite alot.